Individual
ANTHONY MAZZEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 S 54TH ST, ACADEMIC ER SVCS - ER DEPT, PHILADELPHIA, PA 19143-1900
(215) 748-9435
Mailing address
12 GILL ST, STE 3000, WOBURN, MA 01801-1728
(781) 937-4522
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD426111
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013185820
—
PA
01
—
1013185820001
PROMISE
PA
01
—
1773372
BS
PA
01
—
2454613000
KEYSTONE
PA
01
—
30026141
KEYSTONE MERCY
PA
Enumeration date
07/03/2006
Last updated
04/29/2008
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